Peri- and Post-Menopausal Women with Schizophrenia and Related Disorders Are a Population with Specific Needs : A Narrative Review of Current Theories
González-Rodríguez, Alexandre (Universitat de Barcelona. Hospital Mútua de Terrassa)
Guàrdia Delgado, Armand (Universitat de Barcelona. Hospital Mútua de Terrassa)
Monreal Ortiz, Jose Antonio (Universitat Autònoma de Barcelona. Institut de Neurociències)

Data:	2021
Resum:	Background: While gender differences in antipsychotic response have been recognized, the potential role of menopause in changing drug efficacy and clinical outcome in schizophrenia related disorders has been understudied. We aimed to review the relevant literature to test whether optimizing menopausal and post-menopausal treatment and addressing specific health needs of this stage in life will improve outcome. Methods: Non-systematic narrative review using the PubMed database (1900-July 2021) focusing on randomized controlled trial results addressing our question. Forty-nine studies met our criteria. Results: Premenopausal women show significantly better antipsychotic response than postmenopausal women. Hormone replacement therapies (HRT) should be used in postmenopausal women with schizophrenia with caution. Raloxifene, combined with antipsychotics, is effective for psychotic and cognitive symptoms in postmenopausal women with schizophrenia and related disorders. Medical comorbidities increase after menopause, but the influence of comorbidities on clinical outcomes has been poorly investigated. Preventive strategies include weighing risks and benefits of treatment, preventing medical comorbidities, and enhancing psychosocial support. Ideal treatment settings for this population warrant investigation. Conclusions: Antipsychotic dose adjustment at menopause is recommended for schizophrenia. Raloxifene may play an important role in permitting dose reduction and lessening adverse effects. Prevention of comorbidities will help to reduce the mortality rate.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Schizophrenia ; Menopause ; Hormones ; Antipsychotics ; Comorbidity
Publicat a:	Journal of personalized medicine, Vol. 11 (august 2021) , ISSN 2075-4426

DOI: 10.3390/jpm11090849
PMID: 34575626

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